So It’s Cancer: now what?

In the same way that this book’s title poses a question, another might be whether patients and their supporters need another advice manual on how to cope with a cancer diagnosis and participate in the management of their condition.

In this case, the answer is a resounding yes, as the author, Melbourne-based oncologist and communicator Dr Ranjana Srivastava combines her clinical expertise and experience, and an excellent facility with words.

Timely in the current health-debate climate, it confirmed Dr Srivastava as a valuable commentator on health issues, earlier contributions being two other books, also with straight-shooting titles, Tell me the Truth and Dying for a Chat, focusing on the patient-doctor nexus.

This time around, the focus is squarely on cancer, a subject she is all too familiar with as is society generally, given today’s cancer rates. However, as the author recounts, “My patients often say that once they heard the word ‘cancer’, every other piece of information just evaporated – everything else seemed like a tide of white noise.”

As a result, “The initial conversation around the disclosure of cancer is important,” words that aptly sum up the immense value of this book, although its scope goes well beyond digesting the initial bad news.

“Unless you are medically trained it may be difficult to comprehend the pathology report or appreciate the changes on a CT scan, but the patients who navigate the journey well are those who always try to understand themselves and their motivations in life.

“They use a personal philosophy to guide them in their decision making, and in doing so, take active control of aspects of their care.”

As a key part of such a control strategy I can think of no better tool than this clearly ordered, compassionately toned and easily understood work. Beginning with an overview “What is Cancer?” chapter, it ranges across the role of the oncologist, treatment modalities, exercise advice, family and sexual relationships, carer support, and, as will be inevitable in many cases, end of life issues such as ‘Palliative Care’ and ‘Advance Care Planning’.

Most helpfully, each chapter ends with a list of key points summarising the text. For instance, following the chapter ‘Will my death be painful?’, Dr Srivastava advises that “pain and other troublesome symptoms are readily manageable with modern means,” and that, “A peaceful death can happen at home, in hospice or in hospital but it helps to articulate your wishes in an advance care directive.”

The chapter “Why Natural Therapies Aren’t the Answer” may have particular resonance in the Northern Rivers. It includes a tragic case history of a patient whose alternative treatment regime for bowel cancer not only failed him but cost a considerable sum that, post mortem, saddled his wife with a substantial debt.

“I should distinguish between complementary therapy such as yoga, meditation and mindfulness activities and alternative therapy consisting of unproved remedies,” the author notes.

“Almost every oncologist acknowledges the importance of tending to the mind-body axis as part of comprehensive cancer treatment. It is when the treatment strays into elimination diets, super foods and vitamin megadoses that oncologists become wary.”

If only for this advice the book would be well worth owning, but clearly there is much more to it, and the package, with a foreword by Cancer Council CEO Prof Ian Olver, is highly recommended to all cancer patients and their supporters.